Journal of ambulatory care marketing最新文献

A case study of the proposed development of a regional children's health care system in South Texas is described. Strategic plans for the system are overviewed and the community response to plans are presented. The political, social responsibility and fiscal viability issues raised are reviewed and the research literature base relevant to the health care needs of a key (Hispanic) market is summarized.

Never before has American society undergone such dramatic and pervasive changes as those currently effecting national health care needs. New strategies to meet the health care needs created by societal changes must be identified. Consumers, employers, providers, and third-party payers are calling for more cost effective health care, better access and better quality. Simultaneously, the United States has a shortage of primary care physicians. While many people claim that one strategy necessary for health care reform is to change the primary care physician/specialty mix of providers, there are some inherent fallacies in this argument. Training for primary care medicine has historically been available; however, the majority of physicians choose specialty practice. The financial rewards are much better in specialty practice than in primary care. If the U.S. were to alter the reward structure and make primary care more attractive to physicians, the objective of controlling costs could not be met. However, there is another alternative and that is to change the provider mix. Since advanced practice nurses (APNs) have a long and successful history of taking care of primary care patients, why not make them the point of first contact? APNs working collaboratively with physicians could more cost effectively manage care for large numbers of ambulatory patients than are being adequately handled at present. APNs, defined as nurse practitioners, certified nurse midwives and clinical nurse specialists, provide high quality, cost effective, and comprehensive primary care services. Increased use of APNs in disease prevention, illness management, and health education is one way of meeting health care needs of Americans. Innovative strategies for more effectively using APNs must also be identified and implemented. Also, artificial and politically imposed barriers to effective utilization of APNs must be removed.

Reference price has been postulated in the consumer behavior literature to be an important determinant of new product acceptance in the marketplace. This study was undertaken to assess the influence of reference price on the acceptance of new healthcare transportation services among the elderly. Over five hundred elderly, chosen at random, were studied in a major metropolitan area. The proposed new healthcare transportation services were: a shuttle service (from the hospital to a satellite healthcare center) and an escort service (from the hospital to the patient's home). The results show that reference price is the main influence on the acceptance of the shuttle service superseding the effects of the traditional demographic variables of gender and marital status. However, reference price was not found to be an influence on the acceptance of the escort service. It appears that the use of reference price as a guide in the acceptance of a new product is not universal but rather contingent on the product being offered.

Today's health care environment is characterized by burgeoning costs and increasing concern about service quality. Not surprisingly, researchers and practitioners are turning to Total Quality Management (TQM) in their quest for creating high quality health care delivery systems. Despite the central importance of TQM, there is practically no common definition of total quality in medical care research. In this paper, we trace the historical development of the quality concept, offer a valid definition of "total quality," and detail a comprehensive model of TQM for health care research. Implications of our model for academicians and practitioners are discussed.